# WALGREEN CO

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WALGREENS BOOTS ALLIANCE INC
- **Other names:** Ava Drug \#15726, Powered by Walgreens
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1497785398
- **Legal business name:** WALGREENS BOOTS ALLIANCE INC
- **Authorized official:** JENNIFER PONCE (MANAGER)
- **Authorized official phone:** (847) 527-2489

## Contact information

- **Practice address:** 124 W WASHINGTON AVE, AVA, MO 65608-6504
- **Practice address phone:** (417) 683-4127
- **Practice address fax:** (417) 683-6160
- **Mailing address:** 1901 E VOORHEES ST, MS 790, DANVILLE, IL 61834-4509
- **Mailing address phone:** (847) 527-2489
- **Mailing address fax:** (217) 709-2344

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | — | — |
| 333600000X | Pharmacy | 2017006067 | MO | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | — | — |

## Other

- **Enumeration date:** 07/04/2006
- **Last updated:** 03/28/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2601981 | OTHER ID NUMBER | — |
| 05 | — | 600123301 | — | MO |